"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

Dr. Wilber Su,Cavanaugh Heart Center, Phoenix, AZ

"...masterful. You managed to combine an encyclopedic compilation of information with the simplicity of presentation that enhances the delivery of the information to the reader. This is not an easy thing to do, but you have been very, very successful at it."

Ira David Levin, heart patient, Rome, Italy

"Within the pages of Beat Your A-Fib, Dr. Steve Ryan, PhD, provides a comprehensive guide for persons seeking to find a cure for their Atrial Fibrillation."

Walter Kerwin, MD, Cedars-Sinai Medical Center, Los Angeles, CA

65 and Older: 99% Have Microbleeds—So Are Anticoagulants Risky?

PublishedMarch 28, 2016

In a recent study, 99% of subjects aged 65 or older had evidence of microbleeds; and closer examination of the cranial MRI images revealed an increased number of detectable microbleeds (i.e. the closer they looked, the more microbleeds they found).

Microbleeds in the brain are thought to be a precursor of hemorrhagic stroke.

Cerebral microbleeds (CMBs) are small chronic brain hemorrhages of the small vessels of the brain.

If Microbleeds Cause Hemorrhagic Stroke, Should I be on a Blood Thinner?

The fact that almost everyone 65 or older has microbleeds is astonishing and worrisome, particularly if you have A-Fib and have to take anticoagulants. Anticoagulants cause or increase bleeding. That’s how they work.

In plain language, this study indicates that cerebral microbleeds lead to or cause hemorrhagic stroke. It’s not surprising then that some doctors are reluctant to prescribe heavy-duty anticoagulants to older A-Fib patients.

Being older and already having microbleeds only makes taking anticoagulants all the more worrisome.

Risks of Taking Anticoagulants (Blood Thinners)

Taking almost any prescription medication has trade-offs. Older A-Fib patients find themselves between a rock and a hard place.

In the case of anticoagulants, on one hand you get protection from having an A-Fib stroke (which often leads to death or severe disability), but on the other hand you have an increased risk of bleeding.

For those over 65 who already have microbleeds, there’s a substantial downside to taking anticoagulants: an increased risk of hemorrhagic stroke, developing dementia, and other problems.

My pet peeve about these ads: Being on a blood thinner for stroke risk does nothing to treat your A-Fib. So what’s to be overjoyed about? You still have A-Fib!

But taking an anticoagulant is not like taking daily vitamins. (For example: If you take too much Vitamin C, your body expels the excess through your urine. No harm done.)

Contrary to these ads, you can’t just take an anticoagulant and live happily ever after with your A-Fib. That’s fantasyland!

In the case of the relatively young Kevin Nealon, he’s looking at 20-25+ years of life-long anticoagulation. Most Electrophysiologists (EPs) would have serious, second thoughts about leaving someone on anticoagulants for that long. See my article, All Anticoagulants Cause Bleeding.

Safer, Healthier Alternatives to Anticoagulants

Don’t worry, there are alternatives to taking anticoagulants that are better, more sane and healthier.

The #1 best way to avoid anticoagulants: No longer have A-Fib! No A-Fib, no increased risk of stroke (common sense, right?).

Catheter ablating pulmonary vein

Request a catheter ablation procedure. Today, you can have an ablation immediately (called ‘first-line therapy’ by your doctor). You don’t have to waste a year on failed drug therapy.

An ablation is the least invasive treatment for A-Fib and has a 70%–85% cure rate (that rises to over 90% is a second ‘touch-up’ ablation is needed).

(There are surgical treatments, but they’re not recommended as a first option as they are more invasive, traumatic, risky and with longer recovery times.)

The #2 best way to avoid anticoagulants:Close off your Left Atrial Appendage (LAA). This is where 90%-95% of A-Fib clots originate.

Catheter placing Watchman in LAA

Request a Watchman device. The Watchman device is inserted to close off your LAA to keep clots from entering your blood stream.

You Won’t Hear it from the Media

Of course, you won’t hear about these alternatives in those TV ads for anticoagulants.

Why? Being cured of A-Fib or no longer needing anticoagulants means big Pharma will lose a life-long drug customer (like Kevin Nealon who’s looking at 20-25+ years on Xarelto).

Most media outlets won’t tell you about these alternatives either. Today’s media companies are either owned, operated, supported or influenced by drug companies. For example, WebMD.com and TheHeart.org are controlled and operated by, among others, the drug company Eli Lilly.

What this Means to Patients Over 65

CT of brain with Ischemic stroke

Start a dialog with your doctor about microbleeds and the associated risks of taking anticoagulants at your age. Ask questions such as:

• “I probably have microbleeds, so will taking anticoagulants increase the microbleeds (and lead to other health problems, increased risk of dementia, etc.)?”
• “As I get older and keep taking anticoagulants, how much more am I at risk of developing microbleeds and a hemorrhagic stroke?”

Consider non-prescription blood thinners.Ask about your CHADS2 or CHA2DS2-VASc score (stroke risk assessors). If your CHADS2 score is a 1 or 2, ask if you could take a non-prescription approach to stroke prevention.

Perhaps you can benefit from an increase in natural blood thinners such as turmeric, ginger and vitamin E or especially the supplement Nattokinase.

Consider Catheter Ablation or the Watchman. To eliminate the need to take blood thinners, consider a catheter ablation to stop your A-Fib. Or consider having a Watchman device installed to reduce or eliminate the need for blood thinners.

Disclaimer: the authors of this Web site are not medical doctors and are not affiliated with any medical school or organization. The information on this site is not intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health professional prior to starting any new treatment or with any questions you may have regarding a medical condition. Nothing contained in this service is intended to be for medical diagnosis or treatment.